lA ETHICS& CAN4PirlGr't

D I S C It - l l t i a I i]tlntrt
DISCLOSURE
SUMMARYPAGE
FOR COUNTY CANDTDATES
JANI;l U1996
F|LEALLREPORTS
Wm{ couNw AUolTrgfrD F ofrlc.urqilf
Coma !{a
be sane as on Statementol Indued
Audlred I Iz ./'

Fr', e*/s /" E/utt $a,ss

I - /L - ?6
SIGNI\TURE OF flllng lh|lr reportl' TELEPHONE DATESIGNED

CAUTION:PenaltesDue For LateFlledRepott RangeFtom 310to $400

REPORTINGDATES- ELECTIONYEAR REPORTINGDATES- NONELECTION

YEAR
Reoorl Due Corered perlod Reoorl Due Coversd Perlod
tr May20,19 Jan. I - May15,19
tr July 20,19- May16- Juty 15,t9 {l*.2o,833- Jan.l -Dec.g1,1gE-
tr Oct 20,19 Juty t6 - Oct tS, t9_
E Jan.20,19 Octl6-Dec.gt,lg_
eA pp.Ng
tr Checkil Amendmentto reportdated
tr check if ffnal(termination)repoa (AttachNotteeof Dtssotutton
Form DR-3)
t 6 lg95

STATEI'ENT OF CASH ON HAND

2,/%. o7
4DD TOTAL irONEr TAKEN tN THIS pERtOD
Schedule A\: Cash Contributons total (Attach Schedute A)
Schedule C: Fundraising Eventstotat (Atbch Schedute C) ......
Schedule F: Loans Receivedtotat (Attach Schedule D ....
Schedule H: Total Satesof Gampaignproperty (Athch Schedule H) ....
SUE.TOTAL
SUBTRACTTOTAL IIONFT SPENTTHIS PERIOD
Schedule B: E:cpenditure totat (Attach Schedufe B) .... t2-e2.60
Schedule F: Loan Repaymentsrotat (Attach Schedute R . . . - .
CASH Ot{ HAND at the end of this repor0ngperiod (it linal repo( blancc mr.lstbe zero}
(Athch DR-3) s 2O-/.O7 ,/

UtlPAlD BIIIS (Frorn ScheduteD -Attach Schedute D)

lN KIND CONTRIBUTIONS (From Schedute E-Attach Schedute E)
$-E -o-
OUTSTANDING LOANS (From ScheduteF-Attach Schedute F) -Tf
CONSULTANT BREAKDOWN(ScheduteG anached?) y* N.
VALUE oF cAtPAtcN PRoPERTY(From Schedute H -Aterch Schettute H) _d-

'REUINDER:Tho law placts responrlblllty

sotely upon lhe candlrtatetor thc tlmetlnes and eccrincy of raportt llled by
lhe conmlltee feasurer.

r.o.oBl?/cPr-oa0!i20
 SCHEDULE
- MONEYSPENT
EXPENDITUBES
B I #3$5H,1,
CANDIDATE
Forofllce uee onlv

CANDIDATES COMMITTEENAME(Must be sameas on Statementof Organization)

F"',*nJ s fo E/e*,f Ba
NAME ANDADDRESS TO WHOMEGENDITURE
Disbursement)
WAS MADE

!<(4wsont -Ia<Ksol
C,e'7 bia*te+u

SUB.TOTAL

TOTAL (lt last pge ol thls schedule)

Campaignfunds may be used only for campalgn purposes, constituency expenditures and educational and other expensesassociated
with duties of offlce.
Purchasesof campaign ProPertymust also be inventoriedon ScheduleH.
Expendituresto consultants(persons/entitiesprovidingconsulting,advertislng,fundraising,polling, managing,organizingservices'
eii.f must aiso Oe detait ite;?ized on Schedute G bithe amouii, purpose, and date of each type of expenditure made by the
con'sultanton behalf of the candidate'scommittee.See manual for more specific instructions. t ,
f o1 I
1993)
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